| NPI | 1518105105 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: OR MD176052) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MO 2011012788) |
| 208000000X Pediatrics (Licence: AL 17142) | |
| 208000000X Pediatrics (Licence: CA G89409) | |
| Enumeration Date | 2009-02-04 |
| Last Update Date | 2019-07-08 |